Complete Semen Analysis Research Articles

Impaired Semen Quality in Patients with Chronic Prostatitis.

Background/Objectives: Chronic prostatitis/chronic pelvic pain syndrome CP/CPPS is a rather common condition and in recent years many studies have shown contradictory results regarding its impact on semen quality. This prospective cohort study set out to investigate how CP/CPPS affected the parameters of semen in a prospective cohort of patients compared with the WHO 2021 reference group. Methods: From 2013 to 2022, a total of 1071 patients with suspicion of CP/CPPS received a comprehensive andrological examination. Complete semen analysis was carried out in compliance with WHO 2010 guidelines, comparing every study population semen variable to the WHO 2021 reference group (n~3500). Results: All evaluated semen parameters had median values that fell within a normal range. Nonetheless, approximately 25% of patients had values for each semen variable that were lower than the WHO reference group's fifth percentile. In particular, bacteriospermia was associated with a negative impact on semen volume. Conclusions: This is the largest study that compares all standard semen parameters in patients suffering from CP/CPPS to WHO 2021 reference values. It provides evidence of an impairment of conventional semen parameters.

Effect of physical activity on erectile and sexual function in healthy males

Physical activity (PA) has beneficial effects on erectile dysfunction (ED). It has been proposed to affect ED physiologically via the vascular and nervous systems. This study aimed to evaluate the effect of physical activity on endothelial erectile function, sex hormones and sperm production in healthy males. Sixty-one healthy men aged 18–35 years were eligible to participate in this biochemical and questionnaire-based study. The participants were classified into two groups according to their physical activity level: a physically active group (PA = 38) and a physically inactive group (PINA = 23). PA was evaluated using the ACTi graph GT1M accelerometer. Erectile function was evaluated using the International Index of Erectile Function (IIEF-15) questionnaire. The levels of the sex hormones testosterone (T) and free testosterone (f-T), and the nitric oxide (NO) and E-selectin levels were measured by enzyme linked immuno sorbent assay (ELISA). In addition, a complete semen analysis was performed for all subjects. Better sperm production was reported in physically active subjects than in nonactive subjects. There was a significant increase (p = 0.001) in the IIEF-15 score, and the levels of T, f-T, NO and E-selectin were estimated in physically active subjects compared with those in nonactive subjects. Erectile function (IIEF-15 score) correlated positively with PA and with increased levels of T, f-T, NO and E-selectin, whereas the IIEF-15 score correlated negatively with age and adiposity. Seminological parameters such as the spermatozoa concentration, sperm viability, motility, morphology and normal forms were significantly improved in physically active subjects. Physical activity at mild to moderate levels is significantly associated with improved erectile function, increased endothelial function, increased sex hormone levels and better sperm production in healthy men aged 18–35 years. This study proposes that physical activity physiologically affects erectile function and spermatogenesis via cellular free radical-antioxidant mechanisms.

Epidemiology of sperm DNA fragmentation in a retrospective cohort of 1191 men.

The scientific and clinical communities now recognize that sperm DNA integrity is crucial for successful fertilization, good embryo development, and offspring quality of life. Despite the apparent unanimity, this criterion is rarely evaluated in clinical practice. We evaluated the sperm DNA fragmentation index of nearly 1200 sperm samples and its connections based on the patient's age, body mass index, the season of sperm collection, geographical location, medical history, and addictive behaviors. A cohort of 1503 patients who were referred to the Royan Institute between July 2018 and March 2020 was examined. Only 1191 patient records with demographic data, complete semen analysis, and DNA fragmentation index measurements were included in the final cohort. Documents were classified, incorporated into statistical models, and analyzed. The results confirmed previous findings that the sperm DNA fragmentation index was significantly higher in aging men. The sperm DNA fragmentation index and high DNA stainability levels were significantly higher in spring and summer samples than in those of other seasons. No correlation was found between semen DNA fragmentation index and patient body mass index, although the study cohort was significantly overweight. Contrary to what might be expected, we observed that the sperm DNA fragmentation index was higher in rural than in urban patients. Intriguingly, epileptic patients exhibited significantly higher sperm DNA fragmentation index levels. Age is the factor that is most strongly associated with sperm DNA fragmentation index levels. Our analysis of 1191 samples indicates that between the ages of 19 and 59, the sperm DNA fragmentation index increases by an average of 2% each year. Intriguingly, from an epidemiological perspective, the warm season (spring/summer) is associated with a higher sperm DNA fragmentation index in the study population, possibly due to the deleterious effect of temperature on sperm quality. Some neurological diseases, such as epilepsy, are associated with decreased sperm DNA integrity. This observation could be related to the iatrogenic effects of associated therapies. In the study cohort, body mass index did not appear to be correlated with the DNA fragmentation index.

Impact of Chronic Hepatitis B Virus Infection On Semen Parameters of Fertile Men

Aim: To investigate the effect of chronic hepatitis B virus (CHB) infection on semen parameters of males with proven fertility. Material & methods: 61 fertile men with CHB infection and a control group of 42 HBV-negative fertile men were assessed for serum and semen HBV viral loads by quantitative real-time PCR, complete semen analysis, hypo-osmotic swelling test, seminal total peroxide, total antioxidant capacity assay and sperm DNA integrity evaluation. Results: CHB men demonstrated significantly lower sperm motility, sperm viability and sperm DNA integrity, seminal total antioxidant capacity assay and significantly increased seminal total peroxide and oxidative stress index compared with controls. CHB cases with positive semen HBV DNA showed a significant increase in seminal total peroxide and oxidative stress index compared with CHB cases with negative semen HBV DNA. Conclusion: CHB has a negative burden on seminal parameters in fertile men.

Low total motile sperm in transgender women seeking hormone therapy.

This study was undertaken to compare semen quality, hormonal status, and social factors in transgender women seeking fertility preservation with those of fertile cisgender men. Long-range goals are to establish standard practice measures ensuring optimum semen quality for cryopreservation and fertility preservation in transgender women. This is a case-control study carried out at an academic medical center. Cases are transgender women seeking fertility preservation prior to initiation of hormone therapy. Controls are cisgender men recently fathering a child. All participants completed the Depression Anxiety Stress Scales 21 survey and additional survey questions related to personal behaviors. Complete semen analysis was carried out in a clinical andrology laboratory according to WHO guidelines, 5th edition. Serum follicle stimulating hormone, estradiol, and testosterone were measured at the time of semen analysis. Sperm concentration, total sperm per ejaculate, total motile sperm, volume, and normal sperm morphology were significantly lower in transgender females compared with fertile cisgender men. Other measures of semen parameters and hormone concentrations were not different between groups. Survey results indicated transgender women were more likely to have symptoms of depression, anxiety, and stress and utilize tucking and tight undergarments, compared with controls; however, both groups reported similar numbers of ejaculations per week. Although semen parameters were low, cryopreservation of sperm prior to hormone therapy is a viable fertility preservation option for most transgender women. The etiology of the differences in semen parameters is not known. Enhanced education related to personal behaviors or treatment to reduce effects of stressors prior to cryopreservation may improve future fertility potential.

Decreased very long chain polyunsaturated fatty acids in sperm correlates with sperm quantity and quality.

To determine if levels of very long chain polyunsaturated fatty acids (VLC-PUFA; ≥ 28 carbons;4-6 double bonds) in human sperm correlate with sperm quantity and quality as determined by a complete semen analysis. Ejaculates from 70 men underwent a complete semen analysis, which included volume, count, motility, progression, agglutination, viscosity, morphology, and pH. For lipid analysis, sperm were pelleted to remove the semen. Lipids were extracted from the cell pellet and methyl esters of total lipids analyzed by gas chromatography. The sphingolipids were enriched and sphingomyelin (SM) species measured using tandem mass spectrometry. Pair-wise Pearson correlation and linear regression analysis compared percent VLC-PUFA-SM and percent docosahexaenoic acid (DHA) to results from the semen analysis. VLC-PUFA-SM species having 28-34 carbon fatty acids were detected in sperm samples, with 28 and 30 carbon VLC-PUFA as most the abundant. The sum of all VLC-PUFA-SM species comprised 0 to 6.1% of the overall SM pool (mean 2.1%). Pair-wise Pearson analyses showed that lower levels of VLC-PUFA-SM positively correlated with lower total motile count (0.68) and lower total count (0.67). Total VLC-PUFA-SM and mole % DHA (22:6n3) were not strongly correlated (- 0.24). Linear regression analysis confirmed these findings. This study revealed a positive correlation between the levels of VLC-PUFA with sperm count and total motile count and suggests that both sperm quality and quantity may depend on the presence of VLC-PUFA. The lack of correlation between VLC-PUFA and DHA suggests that low VLC-PUFA levels do not result from inadequate PUFA precursors.

Childhood Cancer Risk in the Siblings and Cousins of Men with Poor Semen Quality

Poor semen quality is associated with reduced somatic health and increased cancer risk. Infertility and cancer are increasingly being linked by epidemiologists and basic scientists. We sought to identify semen parameters associated with an increased childhood cancer risk in the family members of subfertile men. We performed a retrospective cohort study in men from the SHARE (Subfertility Heath and Assisted Reproduction) study who underwent semen analysis between 1994 and 2011. We used fertile population controls from the Utah Population Data Base. Our primary outcome was the risk of any childhood (18 years or younger) cancer in the siblings and cousins of men who underwent semen analysis compared to fertile, age matched controls. Cox proportional hazard regression models were used to test the association between semen quality and childhood cancer incidence. We selected 10,511 men with complete semen analysis and an equal number of fertile controls. These men had a total of 63,891 siblings and 327,753 cousins. A total of 170 and 958 childhood cancers were identified in siblings and cousins, respectively. The 3 most common cancers diagnosed in siblings were acute lymphoblastic leukemia in 37, brain cancer in 35 and Hodgkin lymphoma in 15. Oligozoospermia was associated with a twofold increased risk of any childhood cancer and a threefold increased risk of acute lymphoblastic leukemia in the siblings of subfertile men compared to fertile controls (HR 2.09, 95% CI 1.18-3.69 vs HR 3.07, 95% CI 1.11-8.46). Siblings of men with oligozoospermia are at increased risk for any-site cancer and acute lymphoblastic leukemia. This suggests a shared genetic/epigenetic insult or an environmental exposure that merits further investigation.

Effect of oral administration of Tribulus terrestris extract on semen quality and body fat index of infertile men.

Male fertility can be evaluated through complete semen analysis. Plants belonging to the Tribulus genus are known for their role in enhancing sex hormone levels and semen quality. The aim of this study was to evaluate the effects of T.terrestris on semen quality and physiological parameters. Sixty-five men with abnormal semen evaluation were included in this study, in which they were prescribed with oral administration of Androsten® (250mg of Tribulus terrestris dried extract per capsule). Body fat percentage, lean muscle mass gain, fluctuation in steroid hormone levels and all semen parameters were analysed during the period of treatment. The results demonstrated that decrease in the percentage of body fat and increase in lean mass were significant, as well as increase in dihydrotestosterone levels. Complete semen analysis evaluated at the end of treatment showed significant enhancement in sperm concentration, motility and liquefaction time. Protodioscin, the main phytochemical agent of the Tribulus genus, acts on sertoli cells, germ cell proliferation and growth of seminiferous tubules. This component is known to convert testosterone into dihydrotestosterone, which plays important roles in male attributes. Our results indicate the therapeutic use of Tribulus terrestris by men presenting altered semen parameters, and/or undergoing infertility treatment.

Semen quality in HIV patients under stable antiretroviral therapy is impaired compared to WHO 2010 reference values and on sperm proteome level

To investigate semen quality in HIV patients under stable antiretroviral therapy (ART) compared with WHO 2010 reference values and on the sperm proteome level. Between 2011 and 2013, we prospectively enrolled 116 HIV-positive men without hepatitis B or C co-infections from our outpatient department for infectious diseases. Patients received a comprehensive andrological work-up. Complete semen analysis was performed according to WHO 2010 recommendations, with each semen variable of the study population being compared with the WHO reference group (n~2000). Correlation analysis was done to investigate the influence of HIV surrogate parameters on semen quality. Two-dimensional gel electrophoresis and subsequent protein identification was performed to determine any differences in the sperm protein composition of the 15 HIV-positive patients and that of 15 age-matched healthy men. Median values of all assessed semen parameters were within a normal range. However, for each semen variable, about 25% of patients had values below the fifth percentile of the WHO 2010 reference group. Disease-related parameters (CD4þ cell count, viral load, CDC stage, duration of disease, duration of ART, number and type of antiretroviral drugs) were not significantly correlated with any sperm parameter. Sperm proteome analysis identified 14 downregulated proteins associated with sperm motility and fertility. This is the first study that compares all standard semen parameters in HIV positive patients under ART to WHO 2010 reference values. It provides evidence of impaired conventional semen parameters and altered sperm protein composition. Finally, HIV surrogate parameters are not suitable for predicting semen quality.

Effect of number of mounts and pre-freeze concentration on stallion seminal parameters

Frozen stallion semen is becoming increasingly more prevalent in the equine industry. Advantages to using frozen semen include the convenience of collecting and freezing semen from stallions during their competitive or non-breeding season, along with indefinite semen storage and the possibility of producing offspring after a stallion’s death. The objectives of this retrospective study were (1) to determine how the number of mounts on the phantom affected pre-freeze sperm motion characteristics and sperm output and (2) to determine how pre-freeze sperm concentration affected post-thaw sperm motion characteristics. Data were available from a commercial company (Select Breeders Services, Chesapeake City, Maryland). Ejaculates with complete computer-assisted semen analysis (CASA) information from 1996 to 2012 were included in the analysis. These data included 12,397 ejaculates from 761 stallions with at least three ejaculates per stallion. Seminal parameters investigated included total motility (%), progressive motility (%), average path velocity (mm/ sec), concentration (106/mL), total sperm (109), and gelfree volume (mL). Data were analyzed by mixed ANOVA and protected LSD. Results are expressed as least squares means standard error. As number of mounts per ejaculate increased (range: 1-8 mounts), gel-free volume (ml)

Mating behavior and fertility of broiler breeder males reared on shortened growth cycles

SUMMARY One of the more difficult tasks when raising broiler breeder cockerels is controlling BW gain in the rearing house without inflicting excess stress. This is a period of time for the young male when many portions of the reproductive system are in the formative stages and, if neglected, can have lifelong effects on their reproductive performance. The objective of this study was to raise males under feed management programs that produced the recommended target BW of 3,060 g for males at 12, 15, 18, 21, and 24 wk of age. Males were placed at 3-wk intervals so that all males with the same BW were light stimulated at the same time but at different ages. All males were reared in the same light-controlled house at the University of Arkansas Research Farm. Males were light stimulated, and testes development, complete semen analysis, fertility, and mating activity and behavior were recorded for each group of males. At the time of light stimulation, the younger males were less successful at completing matings, crowed less often, and showed less wing flapping and neck flaring than older males, based on the results for mating behavior. Males that were older at the time of light stimulation had higher fertility than younger males. Males that were 24 wk old at the time of light stimulation had an overall fertility of 94.5%, compared with 91.8, 91.6, 79.2, and 87.3%, respectively, for the other ages. In this study, we found that males that were exposed to light at earlier ages exhibited less overall mating activity than older males.

Antioxidants intake and semen quality in men attending a fertility clinic

To evaluate whether the intake of the antioxidant vitamins A, C and E and carotenoids is associated with semen quality parameters in a population of men seeking fertility evaluation. Cross-sectional study. Male partners of couples attending the Massachusetts General Hospital Fertility Center were invited to participate in the study. Intakes of vitamins A, C and E and carotenoids were assessed using a previously validated food frequency questionnaire. Semen quality was assessed manually and by computer-aided semen analysis. 99 men with complete semen analysis and diet data were included in the analysis. Linear regression was used to analyze the association of each micronutrient with semen quality parameters adjusting for total energy intake, age, race/ethnicity, body mass index, smoking, intakes of alcohol and caffeine, abstinence time and previous infertility exam. Age was positively associated with higher intakes of vitamins A, C, E and carotenoids. Men with previous infertility exams were more likely to use vitamin A supplements. Vitamin A intake was significantly associated with lower sperm motility and morphology (P=0.01, 0.005 respectively) and moderately associated with lower sperm concentration (P=0.06).These associations were driven by intake of supplements. Vitamin A intake from foods sources alone was unrelated to semen quality. Men in the highest quartile of alpha carotene intake had 2% (-3.7%, -0.4%) fewer morphologically normal spermatozoa than those in the lowest quartile (p-trend = 0.02).There was no association between vitamin C and E with semen quality. Dietary intakes of vitamins A, C and E were unrelated to semen quality parameters. There is a suggestive association between alpha carotene intake and inferior sperm morphology.

Abnormal sperm count and motility on semen analysis are not sufficiently predictive of abnormal Kruger morphology

Abnormal morphology by Kruger's strict criteria cannot be predicted reliably by the presence of other abnormal parameters on semen analysis. Assessment of Kruger morphology therefore remains a necessary component of a complete semen analysis in the workup of the infertile couple.

Male infertility in China: laboratory finding for AZF microdeletions and chromosomal abnormalities in infertile men from Northeastern China

To investigate the frequencies of AZF microdeletions and chromosomal abnormalities in infertile men from Northeastern China. Moreover, to compare the prevalence of these abnormalities with other countries and regions in the world. 305 infertile men were enrolled. A complete semen analysis and reproductive hormones were measured according to standard methods. Multiplex polymerase chain reaction (PCR) amplification using nine specific sequence-tagged sites (STS) were used to detect AZF microdeletions. Karyotype analyses were performed on peripheral blood lymphocytes with standard G-banding. Of the 305 infertile men, 28 (9.2%) had AZF microdeletions and 26 (8.5%) had chromosomal abnormalities. The most frequent microdeletions were in the AZFc+d, followed by AZFc, AZFb+c+d and AZFa. A total of 19 patients (82.6%) had Klinefelter's syndrome (47, XXY) in the azoospermic group. The freqencies of AZF microdeletions and chromosomal abnormalities in infertile men from Northeastern China were comparable with infertile men from other countries and regions. However, there was a slightly higher prevalence rate of AZF microdeletions in oligozoospermic patients than reported in previous studies.

P-575: Seminal fibronectin in certain cases of male infertility

ObjectiveFibronectin is a dimeric filament forming glycoprotein. It is a secretory product of accessory sex glands. fibronectin is a major compound of the human seminal gel and also pointed to its potential role in sperm trapping in it. It may play a major role in sperm-egg interaction. The objective was to study seminal fibronectin level in certain cases of male infertility in relation to other variables.DesignA prospective studyMaterials and methodsA study on 30 infertile men grouped into three groups with asthenozoospermia (9 cases), asthenoteratozoospermia (10 cases), and oligoasthenoteratozoospermia (11 cases). Ten fertile normozoospermic men were selected as control group. Thorough history and full clinical examination were done with complete semen analysis using a simple computer-assisted (Autosperm) method. Seminal plasma fibronectin was measured by Radial Immune Diffusion plate. Serum testosterone and F.S.H. levels were detected using enzyme immunoassay.ResultsHigh significant increase of seminal plasma fibronectin levels were detected among different infertile groups compared to control one. Significant negative correlation was found between fibronectin level and grade (A, B and A+B) motility. There was a significant negative correlation between fibronectin level and sperm velocity, linear velocity and linearity index. Fibronectin was negatively correlated with serum testosterone level while seminal WBCs count was positively correlated significantly.ConclusionDecrease sperm motility is found in association with increase concentration of fibronectin in seminal plasma. This may add a diagnostic tool for patients with unexplained infertility and would provide an important lead to develop new therapeutic strategies directed towards the mechanisms of male infertility. ObjectiveFibronectin is a dimeric filament forming glycoprotein. It is a secretory product of accessory sex glands. fibronectin is a major compound of the human seminal gel and also pointed to its potential role in sperm trapping in it. It may play a major role in sperm-egg interaction. The objective was to study seminal fibronectin level in certain cases of male infertility in relation to other variables. Fibronectin is a dimeric filament forming glycoprotein. It is a secretory product of accessory sex glands. fibronectin is a major compound of the human seminal gel and also pointed to its potential role in sperm trapping in it. It may play a major role in sperm-egg interaction. The objective was to study seminal fibronectin level in certain cases of male infertility in relation to other variables. DesignA prospective study A prospective study Materials and methodsA study on 30 infertile men grouped into three groups with asthenozoospermia (9 cases), asthenoteratozoospermia (10 cases), and oligoasthenoteratozoospermia (11 cases). Ten fertile normozoospermic men were selected as control group. Thorough history and full clinical examination were done with complete semen analysis using a simple computer-assisted (Autosperm) method. Seminal plasma fibronectin was measured by Radial Immune Diffusion plate. Serum testosterone and F.S.H. levels were detected using enzyme immunoassay. A study on 30 infertile men grouped into three groups with asthenozoospermia (9 cases), asthenoteratozoospermia (10 cases), and oligoasthenoteratozoospermia (11 cases). Ten fertile normozoospermic men were selected as control group. Thorough history and full clinical examination were done with complete semen analysis using a simple computer-assisted (Autosperm) method. Seminal plasma fibronectin was measured by Radial Immune Diffusion plate. Serum testosterone and F.S.H. levels were detected using enzyme immunoassay. ResultsHigh significant increase of seminal plasma fibronectin levels were detected among different infertile groups compared to control one. Significant negative correlation was found between fibronectin level and grade (A, B and A+B) motility. There was a significant negative correlation between fibronectin level and sperm velocity, linear velocity and linearity index. Fibronectin was negatively correlated with serum testosterone level while seminal WBCs count was positively correlated significantly. High significant increase of seminal plasma fibronectin levels were detected among different infertile groups compared to control one. Significant negative correlation was found between fibronectin level and grade (A, B and A+B) motility. There was a significant negative correlation between fibronectin level and sperm velocity, linear velocity and linearity index. Fibronectin was negatively correlated with serum testosterone level while seminal WBCs count was positively correlated significantly. ConclusionDecrease sperm motility is found in association with increase concentration of fibronectin in seminal plasma. This may add a diagnostic tool for patients with unexplained infertility and would provide an important lead to develop new therapeutic strategies directed towards the mechanisms of male infertility. Decrease sperm motility is found in association with increase concentration of fibronectin in seminal plasma. This may add a diagnostic tool for patients with unexplained infertility and would provide an important lead to develop new therapeutic strategies directed towards the mechanisms of male infertility.

P-1001: Poor sperm count or motility predicts Kruger morphology but not sufficiently to forgo morphology testing

A large body of literature demonstrates that sperm from men with extremely poor morphologies using Kruger’s Strict Criteria (< 4% normal) fertilize poorly. These couples benefit significantly from intracytoplasmic sperm injection. Semen analyses performed at general laboratories frequently do not include a strict Kruger morphology assessment. These studies either include no morphology assessment, or use the older WHO criteria for morphology. Clinicians are often asked to use these analyses for clinical decisions, to avoid repeat semen analysis. We therefore wanted to determine the ability of other semen analysis parameters-specifically count and/or motility- to predict normal or abnormal morphology on the strict Kruger morphology scale. Retrospective review of all semen analyses from January 1, 2002 to December 31, 2005 at University Reproductive Associates. Semen analyses were collected from our Andrology laboratory database. The study was approved by the IRB of New Jersey Medical School in Newark, New Jersey. All complete semen analyses were considered. Only the first semen analysis was included for each man (n=1384). All analyses included measurements of count (million/cc), motility (%), and strict Kruger morphology (% normal). Predictive values were calculated to determine if an abnormal sperm count or motility predicted abnormal sperm morphology. Each semen analysis was evaluated and classified by count, motility, and strict Kruger morphology. A significant association exists between Count/Motility and Morphology (P << .005, Chi squared = 221.6 with 1 degree of freedom). The positive predictive value of an abnormal count or motility for a low Kruger morphology was 60% and the negative predictive value was 80%. However, 40% of the specimens with poor count and/or motility had normal morphology greater than or equal to 5%. Twenty percent of the specimens with normal count and motility had normal morphology less than or equal to 4%. The sensitivity was 60% and the specificity was 80%.Tabled 1 Abnormal sperm count and motility were reasonable predictors of abnormal morphology. However, 20% of samples which were normal for both count and motility would go undetected despite their extremely poor Kruger morphology. As sperm morphology is an independently important predictor of sperm fertilization potential, the Kruger morphology remains an important component of the complete semen analysis.

Double-blind Y chromosome microdeletion analysis in men with known sperm parameters and reproductive hormone profiles: microdeletions are specific for spermatogenic failure.

Y chromosome microdeletions have been reported as a possible genetic factor of male infertility. Despite a large number of studies in this subject, there is still considerable debate and confusion surrounding the role of Y chromosome microdeletions in male infertility. This has been further compounded by observations of Y microdeletions in fertile males. The aim of the present study was to evaluate: 1) the incidence of Y microdeletions in control male population and infertile males, where complete semen and hormonal analysis was available to define whether Y microdeletions are specific for spermatogenic failure or if they can be found also in normospermic men; and 2) whether the suboptimal semen quality reported in Denmark is associated with a higher incidence of Y microdeletions in respect to other populations. Double-blind molecular study of deletions was performed in 138 consecutive patients seeking intracytoplasmic sperm injection treatment, 100 men of known fertility, and 107 young military conscripts from the general Danish population. Microdeletions or gene-specific deletions were not detected in normospermic subjects or in subfertile men with a sperm count of more than 1 x 10(6)/mL. Deletions of the Azoospermia factor (AZF)c region were detected in 17% of individuals with idiopathic azoo/cryptozoospermia and in 7% of individuals with nonidiopathic azoo/cryptozoospermia. The data indicate that: 1) the composition of the study population is the major factor in determining deletion frequency; 2) Y chromosome microdeletions are specifically associated with severe spermatogenic failure; therefore, the protocol described here is reliable for the routine clinical workup of severe male factor infertility; and 3) the frequency of Yq microdeletions in the Danish population is similar to that from other countries and argues against the involvement of microdeletions in the relatively low sperm count of the Danish population.

Reproductive function in relation to duty assignments among military personnel

As a follow-up to the pilot study of semen quality of soldiers with various military assignments a larger, more complete study was conducted. Soldiers were recruited at Fort Hood, Texas. Thirty-three men were exposed to radar as part of their duty assignment in the Signal Corps, 57 men were involved with firing the 155 mm howitzer (potential lead exposure), and 103 soldiers had neither lead nor radar exposure and served as the comparison control group. Both serum and urinary follicle-stimulating hormone and luteinizing hormone and serum, salivary, and urine testosterone levels were determined in all men. A complete semen analysis was conducted on each soldier. For statistical analysis, the primary study variables were: sperm concentration, sperm/ejaculate, semen volume, percent normal morphology, percent motile, percent viable (both vital stain and hypoosmotic swelling), curvilinear velocity, straight-line velocity, linearity, sperm head length, width, area, and perimeter. Variables were adjusted for significant confounders (e.g., abstinence, sample age, race). No statistical differences ( P < 0.05) were observed in any measurement. While these results are in agreement with two previous studies assessing soldiers firing the 155-mm howitzer, they contradict our previous report indicating that radar exposure caused a significant decrease in sperm numbers. A possible explanation is that the radar exposure in this study was that used in Signal Corps operations while the men in the previous study were using different radar as part of military intelligence operations. The data presented here in men firing the 155-mm howitzer combined with the results from the previous studies confirms that there are no deficits in semen quality in these men. The contradiction between the results of the radar exposure studies indicates that more data are needed to evaluate the relationship of military radar and male reproductive health.

Immunology and Male Infertility

This article has attempted to review evidence that suggests that immune factors may be operative in a small but significant number of infertile men. Although our current understanding of the possible processes by which autosensitization to previously sequestered reproductive antigens occurs is incomplete, there are laboratory assays presently available that give an indication, but do not prove, that immune factors may be contributing to the infertile state. Continued research is needed to develop new assays and more purified sperm antigens, which might enhance our knowledge of the underlying immunoreproductive changes. Until these are available, the following procedures should be considered when investigating a patient with infertility of suspected immune origin. The patient's history should be taken, and a physical examination should be performed. A complete blood count, urinalysis, and complete semen analysis and culture should be taken. Next, in vivo cervical tests (Sims-Huhner) are performed, followed by sperm antibody assessment (serum, semen) and perhaps in vitro cervical mucus sperm assays (especially the crossed hostility test). After the tests have been completed, the following possibe treatments exist: 1. Treatment of underlying infections 2. Correction of obstructions 3. Corticosteroid (or testosterone?) therapy 4. Washed sperm insemination 5. First portion of fresh ejaculate insemination 6. Artificial insemination with homologous donor 7. Adoption.

Semen Zinc Levels in Infertile and Postvasectomy Patients and Patients with Prostatitis

The semen zinc levels were determined in 18 volunteers, 132 patients postvasectomy, and in 19 patients with prostatitis. The mean values for semen zinc were the same in the volunteers and postvasectomy patients. However, the mean zinc concentration in the volunteers and postvasectomy patients was significantly different from that of the patients with prostatitis. When a group of 12 patients with prostatitis was given supplementary zinc sulfate, the levels of semen zinc rose dramatically and were significantly different from those before treatment. As part of an infertility evaluation, 153 specimens from 72 men who had not fathered a child were examined. A complete semen analysis of each specimen was made, including the semen zinc concentration. The specimens were separated into four arbitrary groups with differing fertility potential. The groups were organized by sperm counts (less than 20 million sperm/ml, 20 to 60 million sperm/ml, 60 to 100 million sperm/ml, and greater than 100 million sperm/ml). There was a trend toward increasing zinc concentrations in the groups with increasing fertility potential. Eleven patients with oligospermia and low semen zinc levels were given supplementary zinc sulfate, 80 mg three times/day for 6 months to 1 year. The parameters of the semen analysis improved in all categories. There were three pregnancies during the period of treatment.